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Evaluating the Effects of Large Scale Health Interventions in Developing Countries: The Zambian Malaria Initiative

Author

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  • Nava Ashraf
  • Günther Fink
  • David N. Weil

Abstract

Since 2003, Zambia has been engaged in a large-scale, centrally coordinated national anti-Malaria campaign which has become a model in sub-Saharan Africa. This paper aims at quantifying the individual and macro level benefits of this campaign, which involved mass distribution of insecticide treated mosquito nets, intermittent preventive treatment for pregnant women, indoor residual spraying, rapid diagnostic tests, and artemisinin-based combination therapy. We discuss the timing and regional coverage of the program, and critically review the available health and program rollout data. To estimate the health benefits associated with the program rollout, we use both population based morbidity measures from the Demographic and Health Surveys and health facility based mortality data as reported in the national Health Management Information System. While we find rather robust correlations between the rollout of bed nets and subsequent improvements in our health measures, the link between regional spraying and individual level health appears rather weak in the data.

Suggested Citation

  • Nava Ashraf & Günther Fink & David N. Weil, 2010. "Evaluating the Effects of Large Scale Health Interventions in Developing Countries: The Zambian Malaria Initiative," NBER Working Papers 16069, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:16069
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    References listed on IDEAS

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    1. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 73-117.
    2. Adrienne M. Lucas, 2013. "The Impact of Malaria Eradication on Fertility," Economic Development and Cultural Change, University of Chicago Press, vol. 61(3), pages 607-631.
    3. Hoyt Bleakley, 2010. "Malaria Eradication in the Americas: A Retrospective Analysis of Childhood Exposure," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 1-45, April.
    4. Adrienne M. Lucas, 2010. "Malaria Eradication and Educational Attainment: Evidence from Paraguay and Sri Lanka," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 46-71, April.
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    1. Ashraf, Fink and Weil - Evaluating the Effects of Large Scale Health Interventions
      by Liam Delaney in Geary Behaviour Centre on 2010-08-18 02:37:00

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    Cited by:

    1. Rodolfo E. Manuelli, 2011. "Disease and Development: The Role of Human Capital," 2011 Meeting Papers 605, Society for Economic Dynamics.
    2. Michael A. Clemens & Gabriel Demombynes, 2011. "When does rigorous impact evaluation make a difference? The case of the Millennium Villages," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 3(3), pages 305-339, September.
    3. Nicholas Wilson, 2015. "Can Disease-Specific Funding Harm Health? in the Shadow of HIV/AIDS Service Expansion," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1671-1700, October.
    4. Portner, Claus C & Beegle, Kathleen & Christiaensen, Luc, 2011. "Family planning and fertility : estimating program effects using cross-sectional data," Policy Research Working Paper Series 5812, The World Bank.
    5. Maria Kuecken & Josselin Thuilliez & Marie-Anne Valfort, 2013. "Does malaria control impact education? A study of the Global Fund in Africa," Documents de travail du Centre d'Economie de la Sorbonne 13075, Université Panthéon-Sorbonne (Paris 1), Centre d'Economie de la Sorbonne.
    6. Jeremy Barofsky & Claire Chase & Tobenna Anekwe & Farshad Farzadfar, 2011. "The Economic Effects of Malaria Eradication: Evidence from an Intervention in Uganda," PGDA Working Papers 7011, Program on the Global Demography of Aging.
    7. Maria Kuecken & Josselin Thuilliez & Marie-Anne Valfort, 2013. "Large-scale health interventions and education: Evidence from Roll Back Malaria in Africa," Documents de travail du Centre d'Economie de la Sorbonne 13075r, Université Panthéon-Sorbonne (Paris 1), Centre d'Economie de la Sorbonne, revised Jun 2015.
    8. Barofsky, Jeremy & Anekwe, Tobenna D. & Chase, Claire, 2015. "Malaria eradication and economic outcomes in sub-Saharan Africa: Evidence from Uganda," Journal of Health Economics, Elsevier, vol. 44(C), pages 118-136.
    9. Demombynes, Gabriel & Trommlerová, Sofia Karina, 2016. "What has driven the decline of infant mortality in Kenya in the 2000s?," Economics & Human Biology, Elsevier, vol. 21(C), pages 17-32.
    10. Rodolfo Manuelli & Emircan Yurdagul, 2021. "AIDS, Human Capital and Development," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 42, pages 178-193, October.
    11. Fink, Günther & Masiye, Felix, 2015. "Health and agricultural productivity: Evidence from Zambia," Journal of Health Economics, Elsevier, vol. 42(C), pages 151-164.
    12. Yoonyoung Cho & David Robalino & Samantha Watson, 2016. "Supporting self-employment and small-scale entrepreneurship: potential programs to improve livelihoods for vulnerable workers," IZA Journal of Labor Policy, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 5(1), pages 1-26, December.
    13. Demombynes, Gabriel & Trommlerova, Sofia Karina, 2012. "What has driven the decline of infant mortality in Kenya ?," Policy Research Working Paper Series 6057, The World Bank.
    14. Wilson, Nicholas, 2015. "Child mortality risk and fertility: Evidence from prevention of mother-to-child transmission of HIV," Journal of Development Economics, Elsevier, vol. 116(C), pages 74-88.
    15. Fink, Günther & Venkataramani, Atheendar S. & Zanolini, Arianna, 2021. "Early life adversity, biological adaptation, and human capital: evidence from an interrupted malaria control program in Zambia," Journal of Health Economics, Elsevier, vol. 80(C).

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    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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